Endothelial Dysfunction Markers Can Predict Diabetes

An increase in sensitive markers of endothelial dysfunction, among them soluble E-selectin (sE-selectin), is associated with an elevated risk of diabetes type 2 in middle-age adults. Senior investigator Dr. Wolfgang Koenig stated that the findings support “the role of endothelial dysfunction in the pathogenesis of type 2 diabetes and also suggest that measures to improve endothelial dysfunction are indicated to prevent or treat type 2 diabetes.”

Dr. Koenig of the University of Ulm Medical Center and colleagues analyzed the results of a case-cohort study, involving 2244 participants.

Using available plasma samples, the researchers measured baseline levels of sE-selectin, soluble intercellular adhesion molecule 1 (sICAM-1) and von Willebrand factor (vWF).

There were 310 cases of incident diabetes in men and 222 in women. After adjustment, men and women with elevated levels of sE-selectin were at significantly increased risk of diabetes.

Compared with those with the lowest levels, men with the highest levels had a hazard ratio of 2.63. For women, the corresponding value was 1.71.

Elevated levels of sICAM-1 were also associated with risk but the association was not independent of other factors including sE-selectin. No association was seen with vWF.

Given the apparent connection, endothelial dysfunction might be reduced by physical activity, weight loss or treatment with statins, ACE inhibitors, glitazones or drugs to increase HDL,” Dr. Koenig suggested. Moreover, more “drugs in this area are under development.”
Arterioscler Thromb Vasc Biol J 2006;26:398-405.